NHS charges

This paper sets out the basis for various NHS charges. It covers exemption criteria and explains variations in the devolved nations. The paper examines recent changes to NHS charges, including the introduction of a hormone replacement therapy (HRT) prescription prepayment certificate in 2023.  It also discusses proposed changes to the charging regime, such as increasing the qualifying age for free prescriptions to align with State Pension age and calls to extend the list of medical exemptions from prescription charges.

The National Health Service Act 1946, which set up the NHS in England and Wales, contained a provision that NHS services should be provided free of charge unless that Act expressly provided for a charge. This provision has been carried forward into the legislation which replaced the 1946 Act – the NHS Act 1977and subsequently the NHS Act 2006.

Since the founding of the NHS, amendments have been made to allow charges for NHS services including prescription, dental and optical charges.

In the context of financial pressure on the NHS, there have been calls for the introduction of additional charges for services, such as GP appointments. There have also been calls to extend free prescriptions, for example to include a wider list of long term conditions for which people are eligible for free prescriptions.

There are separate Library briefings on NHS charges for overseas visitors and NHS hospital car parking charges.